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    JAMA dermatology. 2022 Mar 30. pii: 2790347. doi: 10.1001/jamadermatol.2022.0434
    International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis.
    van Huizen AM1,  Menting SP2,  Gyulai R3,  Iversen L4,  van der Kraaij GE5,  Middelkamp-Hup MA6,  Warren RB7,  Spuls PI8,  Schejtman AA9,  Egeberg A10,  Firooz A11,  Kumar AS12,  Oakley A13,  Foulkes A14,  Ramos AMC15,  Fougerousse AC16,  Carija A17,  Akman-Karakas A18,  Horváth B19,  Fábos B20,  Matlock BH21,  Claréus BW22,  Castro C23,  Ferrándiz C24,  Correa CC25,  Marchesi C26,  Goujon C27,  Gonzalez C28,  Maldonado-García C29,  Hong CH30,  Griffiths CEM31,  Vestergaard C32,  Echeverría CM33,  de la Cruz C34,  Conrad C35,  Törocsik D36,  Drvar DL37,  Balak D38,  Jullien D39,  Appelen D40,  Kim DH41,  de Jong EMGJ42,  El Gamal E43,  Laffitte E44,  Mahé E45,  Sonkoly E46,  Colombo EP47,  Vilarrasa E48,  Willaert F49,  Novoa FD50,  Handjani F51,  Valenzuela F52,  Vílchez-Márquez F53,  Gonzalez GO54,  Krisztián G55,  Damiani G56,  Krnjevic-Pezic G57,  Pellerano G58,  Carretero G59,  Hunter HJA60,  Riad H61,  Oon HH62,  Boonen HPJ63,  Moussa IO64,  García-Doval I65,  Csányi I66,  Brajac I67,  Turchin I68,  Grozdev I69,  Weinberg JM70,  Nicolopoulos J71,  Wells J72,  Lambert JLW73,  Ingram JR74,  Prinz JC75,  de Souza Sittart JA76,  Sanchez JL77,  Hsiao JP78,  Castro-Ayarza JR79,  Maul JT80,  van den Reek JMPA81,  Trcko K82,  Barber K83,  Reich K84,  Gebauer KA85,  Khobzei K86,  Maul LV87,  Massari LP88,  Fardet L89,  le Cleach L90,  Misery L91,  Chandrashekar L92,  Muresanu LI93,  Lecluse L94,  Skov L95,  Frez ML96,  Babic LT97,  Puig L98,  Gomez LC99,  Ramam M100,  Dutil M101,  El-Sayed MH102,  Olszewska M103,  Schram ME104,  Franco MD105,  Llamas-Velasco M106,  Gonçalo M107,  Velásquez-Lopera MM108,  Abad ME109,  de Oliveira MFSP110,  Seyger MMB111,  Kaštelan M112,  Rademaker M113,  Sikora M114,  Lebwohl M115,  Wiseman MC116,  Ferran M117,  van Doorn M118,  Danespazhooh M119,  Bylaite-Bucinskiene M120,  Gooderham MJ121,  Polic MV122,  de Rie MA123,  Zheng M124,  Gómez-Flores M125,  Salleras I Redonnet M126,  Silverberg NB127,  Doss N128,  Yawalkar N129,  Chosidow O130,  Zargari O131,  de la Cueva P132,  Fernandez-Peñas P133,  Cárdenas Rojas PJ134,  Gisondi P135,  Grewal P136,  Sator P137,  Luna PC138,  Félix PAO139,  Varela P140,  Holló P141,  Cetkovska P142,  Calzavara-Pinton P143,  Ghislain PD144,  Araujo RR145,  Romiti R146,  Kui R147,  Ceovic R148,  Vender R149,  Lafuente-Urrez RF150,  Del-Río R151,  Gulin SJ152,  Handa S153,  Mahil SK154,  Kolalapudi SA155,  Marrón SE156,  Azimi SZ157,  Janmohamed SR158,  da Cruz Costa SA159,  Choon SE160,  Urbancek S161,  Ayanlowo O162,  Margasin SM163,  Wong TW164,  Mälkönen T165,  Hurtová T166,  Reciné TR167,  Huldt-Nystrøm T168,  Torres T169,  Liu TY170,  Leonidze T171,  Sharma VK172,  Weightman W173,  Gulliver W174,  Veldkamp W175
    Author information
    Abstract

    IMPORTANCE: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide.

    OBJECTIVE: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics.

    DESIGN, SETTING, AND PARTICIPANTS: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience).

    MAIN OUTCOMES AND MEASURES: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree.

    RESULTS: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients.

    CONCLUSIONS AND RELEVANCE: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.


    Publikations ID: 35353175
    Quelle: öffnen
     
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